Chair's Message – Fourth Wave

As I write this, we are in a third wave of this COVID-19 pandemic as cases and hospitalizations are rising. But, did you know that we are already in a fourth wave, happening right now; that is the wave of patients suffering from depression, anxiety, and other mental health conditions, either new-onset or exacerbated by the pandemic. It is not exactly a wave either; more like choppy seas that will be with us for some time to come.

It is estimated that 40-45 per cent of Canadians feel that their mental health has suffered due to the pandemic. This rises to 60 per cent for Canadians with pre-existing mental health issues. Depression and anxiety are the big items affecting adults, but children are also suffering. Our psychiatric colleagues report that more children are seen now with psychosis, eating disorders, and distorted self-image.

Family doctors are feeling the pressure and looking for help with their patients. Many social workers, psychologists and mental work workers in Family Health Teams are not as available now, certainly for in person care. Virtual visits by telephone or video have been good for some people but may not offer the same help or support for those with mental health conditions.

Here in London/Middlesex, our colleagues in psychiatry tell us that referrals are increasing and wait times for consultation are way up, up to one year for adults. Recently a small group of psychiatrists and family physicians have started meeting to talk about these issues and find potential solutions. The Department of Psychiatry is planning an outreach to family physicians to find out what their needs are and to offer other means of support. Please watch for this sometime in the next two weeks and respond.

Other potential solutions to the backlog are:

  • Expansion of current collaborative care projects
  • Expansion of e-consult program with more involvement with local London-based psychiatrists.
  • A telephone consult program
  • Jointly offered educational programs about major topics like depression., anxiety, substance abuse, using venues like townhall meetings, grand rounds etc.

What would you like to see? What help do you need to support your patients with mental health concerns?

As always, I welcome your comments and feedback at or Twitter @DOCSJW.